Since the 1990-1991 Persian Gulf War, the idea that the health of military personnel returning from major deployments should be monitored proactively has been established. Major studies are under way on both sides of the Atlantic on the health of personnel deployed to Iraq. The research that has emerged so far on US veterans of Operation Iraqi Freedom indicates that there have indeed been many psychiatric casualties, with high prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety. Up to 20% of soldiers and marines returning from deployment to Iraq and Afghanistan met criteria for PTSD.1 Similar findings have been documented by routine screening performed by the US Army.2 The situation for UK personnel returning from Operation TELIC in the 2003 Iraq War is—with the exception of reservists—rather different, with a prevalence of PTSD (measured using identical measures to the US studies) and depressive symptoms similar to those of nondeployed personnel.3 These international differences may in part be explained by the nature of deployments, with US personnel on longer tours of duty in more dangerous parts of Iraq. It also may relate to the populations deployed—the deployed US military personnel are younger and have considerably less experience of active deployment than their British counterparts.3 Whatever the reasons, some of the most significant health effects for returning personnel seem to have been on mental health, and, thus far, there is no evidence of a repeat of the multiple physical symptoms that characterized Persian Gulf War illness.4
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